67218D - Chiarella

LAMA / DREDGE & FILL V I C1 A B C D
GENERAL PERMIT Previous permit #
New El Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources .j 1 l� , ti ll
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ), �� V
❑ Rules
Applicant Name + y Project Location: County�;'�,
Addreyss/ L " ( Street Address/ State Road/ Lot #(s)
�
City C.��n'XU \ GE MState_ ZIP=6b ` G�� �i ` Y
Phone #� _ Oail Subdivision
1
Authorized Agent r(i t >ilr`�G-�^� �J ji . CityZIP
t
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin
�OEA ❑ HHF ElIH ❑ USA El WA t j +
AEC(s): ;❑ PWS. Adj. Wtr. Body �at an unkn
ORW: yes / no PNA yes / no't
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offjbore
Basin, channel
Agent or Applicant Printed,Name .
Signature ` Please �eacl compfthte to nt on back of permit **
Application Fee(s) Check #
(Scale: , I1 �0 ° )
�. ❑ See note on back regarding River Basin rules.
nit Officer's Printed Name
t t re �
iin tier .. -` - wnir�fi n etn
r

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant:`� j�/,� �,�a,
J�^'
Permit �#:
Date:
Describe below the HABITAT disturbances for the application.
All values should
match the name, and units of measurement
found in your Habitat code sheet
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet FINAL Feet
(Applied for,
(Anticipated final
(Applied for. (Anticipated final
DISTURB TYPE
Disturbance total
disturbance.
Disturbance disturbance.
Habitat Name
Choose One
includes any
Excludes any
total includes Excludes any
anticipated
restoration
any anticipated restoration and/or
restoration or
and/or temp .
restoration or temp impact
fomn imnanfe\
import mmnunfl
I famn imnnnfel mmnnnfl
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both [❑ Other []
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑. Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑ .
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

CAMA EMERGENCY GENERAL PERMIT
INFORMATION
Tov. n of Oak Island
C'Ati1A Permit Office
As authorized bv the State of North Carolina
per the Coastal Area Management Act of 1974
Applicant Name Jame 5 Chiaire hr—,
Address
City TtJ. 37321
Phone #
Authorized Agent
'type of Project
1?escription of Activity:
Cost of project:
Notes or special conditions:
ps
�crmcs W. Chiaretta
Owner's Nowt (Print)
Permit #
Project Location Information
Street Address 6125 W . .vC,
N'"• C,
Adj. Water Body LlkYi ic,, OCea h
AEC: ❑ CS ❑ OE ❑ HH ❑ IH
15Z� J, W�A�
wow K COOL,
�con�_durt�s
b
SITE DRAWING
OAK ISLAND DEVELOPMENT SERVICES - 4601

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: dr".M e c W . C hit Q'ce k ac '
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
lQgv (%oLdo4es4itte -B(vd
V n n )c J J( TO _� -7 2 Z
P(P- 402-- 228S
11 Y►1 AA Lj S4L),
/ Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
low 4'(Je r"ark 4
6 sernVida(U CiuV'C
at my property located at 5 i.�, t�eca� ,D 1% 00- k J spa nd k)C. -a-e4 tOr
in BrOr)S W tC. County.
1 furthermore certify that 1 am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
k,SGLn4 e s (,J . G h; r .r l l 04-,
Print or Type Name
Cylk-tn e r
Title
k0 / `,)-g / �o\ (o
Date
This certification is valid through I I

■ service-
CERTIFIEDo RECEIPT
Domestic Mail,
nly
CID
"C 1
U
Certified Mall Fee FF
G
M
Extra Services & Fees (check box, add fee spp op le)
❑ Return Receipt (hardcoPY) $ # I I ! I r r
t i
/� / �y^gyp_
• `' _
❑ Return Receipt (electronic) $ +t i • r` .r
❑ Cenffied Mail Restricted Delivery $ _—T "fir
Postmark
Date
o
❑ Adult Signature Required $_
Here
Lj'.J(
uki Lo` C A � n
❑ Adult Signature Restricted Delivery $
Ad' cen Property Ow er
P Y n
p
r
Postage
$ �ir,y?
�d�
rTl
�
Total Postage and Fees
11 r 1 b/2016
MailinF' AAllre—j
$ ��. ?
Va e_ C. � B�fo
�
Sent To
City, State, Zip Code
i
Street endApf. IVo., or PO �b r /Ao. ---------------------------------------------------
I
Dear Adjacent Property:
This letter is to inform you that I, U% CZhI Q 6!U8— _ have applied for a CAMA Minor
Property Owner ` C�8,/lps-
Permit on my property at �� 1�. Be,aL,_ l r . �C� k 0.N1� lu-� . in`lBrunswick
Property Addr4s
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 8%8- qDz- Z 7,g.5, or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Donna F. Coleman
Local Permit Officer for the Town of Oak Island
4601 E. Oak Island Dr.
Oak Island, NC 28465
Sincerely,
W �
®rop y Owner
1.2�o
Mailing Address
✓* (IP
City, State, Zip Code

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: S 1 am e5 to. Ch t f e I c,
Address of Property: c)c J W �'8QCwC h Dr. Oak Ts lurid PC I
(Lot or Street #, Street or Road, City & County) a SWor
Agent's Name #: VC`�"`��{
Agent's phone #: `110
Mailing Address: IO ? a3b, lg
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing. with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCU) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at t:'ttp.,',U wry.iiccoastalinanaueme.,7LnetlweblctWstaff-list;np orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must
be set back a minimum distance of 15' from my area of riparian access unless waived by me (if
you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Print or Type Name
101(b Chart 64e';Ville -B(-A'
Mailing Address
konyVi Ile -71
City/StateOp
$18�402 ' ZZSS �rnio�y� �c S�1�05.�-r CAM
Telephone Number l/ Email Address
ko�Nib
Date
(Riparian Property Owner Information)
-T'
Sigf nature
1 � Of � Qe., 5,�,�i 0 -
Print or Type Name
Mailing Address
City/Stat&Zip
`-7ni + 39 �►
Telephone Number/Email Address
la�lc`11�
Date
(Revised Aug. 2014)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: ciameS W, C h i are I cu
Address of Property: cl a L (,l.). AWC-h f % Oa L T& 1Q not .0 , C"18 (f to
(Lot or Street #, Street or Road, City & County)
Agent's Name #:
Agent's phone #:
coo 01�D �139
Mailing Address:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
if you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available athttp://www.nccoastalmanagement.net/web/cm/staff-listing orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must
be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If
you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Oure
Print or Type Name
)0 40 Char lo4y', I(t? "BW.
Mailing Address
krl'oxit 11 (!�, iMN 3-74 2 z-
(Ri Prop rty Own rmation)
Signature DovaflAs ZII V
Print or Type Name
Mailing Address
& )f, %fir r rr-s i
City/State/Zip 4 City/State/Zip
8/9- Vv 2 -2Z Ss"
Jlmrx ee CS-�JC It)s ,Cow-zyt-si7D e�/�/ )PA v@N�•kR, eon n
Telephone Number/Email Address Telephone Number I Email Address
io`A1k b � 0
Date Date
(Revised Aug. 2014)